← Return to 60 yr old psa increased from 2 to 3.97 in 1 yr, what should i request

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Profile picture for retireditguy @retireditguy

I agree with the other commentors about finding a urologist and getting a PSE test before a biopsy. When in early 2024 I had a rising PSA that went from 2.8 to 4.25 over about 15 months, my urologist followed a pretty convential path and ordered another PSA test and an MRI (3T) with contrast. The MRI was a piece of cake, but then I'm not claustrophobic. The MRI tech gave me an IV, and then I lay in the MRI for about 20 minutes with a set of headphones playing music. The hardest part was just trying to lay still. The MRI showed a lesion and the radiologist report (which I got at the portal of the lab which did my MRI) said it was PI-RADS 4 (high risk of cancer). Interestingly the follow up PSA had come down to 3.24. I got a 2nd reading of the MRI results and the 2nd radiologist also gave me a PI-RADS 4 so I went ahead and got a fusion biopsy (which gives high confidence they biopsy the actual lesion). The biopsy found plenty of cancer, so the last drop in the psa was a false signal. I guess my point is while there are various ways to proceed, just be sure to follow up on it. It might well be nothing, but if it is prostrate cancer you'll have many more options finding it early as compared to late. BTW, I'm not a medical professional but just a layman, so take my comments with a grain of salt. Best wishes.

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Replies to "I agree with the other commentors about finding a urologist and getting a PSE test before..."

I completely agree with you, retiredguy. My personal narrative mirrors yours very closely. I had my MRI fusion intrarectal biopsy this morning. Both procedures (MRI and biopsy) were easy, then again, I am not queasy or claustrophobic. Besides, my urologist is amazing, and I respect and trust him. The radiologist explained that he could not discern if the sole lesion was PI-RADS 3 or 4; my urologist said that he would call it a PI-RADS 3. Now, I wait for the pathology report -- and go from there. Stay strong, everyone!